REVERSAL OF LIVER FIBROSIS FOLLOWING ANTIVIRAL THERAPY FOR CHRONIC HEPATITIS B AND ITS NON-INVASIVE MONITORING

Abstract. Chronic hepatitis B (CHB) remains a major global health burden, significantly contributing to the development of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Historically, the medical community considered hepatic cirrhosis an irreversible condition. However, clinical and histological evidence now clearly demonstrates that long-term viral suppression achieved through potent antiviral medications—specifically nucleos(t)ide analogues—can halt and reverse the fibrotic process. In many patients, this regression extends to the reversal of early-stage cirrhosis. While liver biopsy has served as the definitive "gold standard" for assessing tissue architecture, its invasive nature has driven the adoption of non-invasive diagnostic modalities. Today, tools such as transient elastography (FibroScan), magnetic resonance elastography (MRE), and serum-based indices (APRI, FIB-4) have revolutionized patient monitoring, offering painless, repeatable alternatives. This article explores the cellular mechanisms of liver regeneration, reviews clinical evidence supporting fibrosis reversal, and examines the practical utility of modern non-invasive diagnostic strategies. Keywords: chronic hepatitis B, antiviral therapy, fibrosis regression, hepatic stellate cells, liver cirrhosis, elastography, APRI, FIB-4 indices.